Diabetes mellitus type 2 or type 2 diabetes (formerly called [non-[insulin]]-dependent diabetes mellitus (NIDDM), or adult-onset diabetes) is a disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. While it is often initially managed by increasing exercise and dietary modification, medications are typically needed as the disease progresses. There are an estimated 23.6 million people in the U.S. (7.8% of the population) with diabetes with 17.9 million being diagnosed, 90% of whom are type 2. Prevalence rates doubled between 1990 and 2005, characterising the increase as an epidemic. Traditionally considered a disease of adults, type 2 diabetes is increasingly diagnosed in children in parallel to rising obesity rates due to alterations in dietary patterns and life styles during childhood. Complex and multifactorial metabolic changes brought about by type 2 diabetes very often lead to damage and function impairment of many organs, most importantly the cardiovascular system. This leads to substantially increased morbidity and mortality in both type 2 patients.
Insulin resistance means that body cells do not respond appropriately when insulin is present. Unlike type 1 diabetes mellitus, the insulin resistance is generally “post-receptor”, meaning it is a problem with the cells that respond to insulin rather than a problem with production of insulin.
Type 2 diabetes may go unnoticed for years before diagnosis, since symptoms are typically milder (eg, no ketoacidosis, coma, etc) and can be sporadic. However, severe complications can result from improperly managed type 2 diabetes, including renal failure, blindness, slow healing wounds (including surgical incisions), and arterial disease, including coronary artery disease. The onset of type 2 diabetes has been most common in middle age and later life, although it is being more frequently seen in adolescents and young adults due to an increase in child obesity and inactivity.
Symptoms of Type 2 diabetes include: excessive urine production; excessive thirst and increased fluid intake; blurred vision; unexplained weight loss; lethargy; fatigue; changes in energy metabolism.
Type 2 diabetes is a chronic, progressive disease that has no established cure. However, there are some treatments which can delay the formerly inevitable consequences of the condition. Type 2 can initially be treated by adjustments in diet and exercise, and by weight loss, most especially in obese patients. Such “life style” treatments can be coupled with the use of diabetes medication, such as metformin (Glucophage), a diabetes medication that lowers glucose production in the liver. Along with metformin, other oral or injected medications can be used to treat type 2 diabetes: some diabetes medications stimulate the pancreas to produce and release more insulin; others block the action of enzymes that break down carbohydrates or make your tissues more sensitive to insulin. Some people who have type 2 diabetes need insulin therapy as well. Weight-loss related surgery can also be used, such as gastric bands.
Nevertheless, despite the disease treatment and management regimes outlined above, the healthcare costs of managing type 2 diabetes and the mortality rate worldwide highlights the need to develop improved medicines for the treatment of this disorder.